GPEI Update: Polio this week – As of 16 April 2014
Global Polio Eradication Initiative
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
[Editor’s extract and bolded text]
:: In central Africa, a new wild poliovirus type 1 (WPV1) case was reported in Equatorial Guinea. In total, three cases have now been reported from the country; genetic sequencing indicates the cases are linked to an ongoing WPV1 outbreak in Cameroon. Outbreak response in the country is currently being planned.
:: On 17 March, the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to ‘very high’. The risk assessment was elevated due to: confirmation of additional WPV1 cases from three new regions of Cameroon confirming continued WPV transmission and geographic expansion of infected areas following detection of four cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic.
:: Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo, and additional immunization activities are being planned in these countries for May.
Pakistan
:: Four new WPV1 cases were reported this week including two from South Waziristan, Federally Administered Tribal Areas – FATA, one from Bannu district, Khyber Pakhtunkhwa (KP), and one from Karachi (Khiorangi), Sindh, bringing the total number of cases for 2014 to 47. The most recent reported case had onset of paralysis on 30 March from Khiorangi, previously a polio-free district…
:: North Waziristan is the district with the largest number of children being paralyzed by poliovirus in the world (both wild and cVDPV2). Immunization activities have been suspended by local leaders since June 2012. It is critical that children in all areas are vaccinated and protected from poliovirus. Immunizations in neighboring high-risk areas are being intensified, to further boost population immunity levels in those areas and prevent further spread of this outbreak.
:: The densely populated Peshawar valley is considered to be the main ‘engine’ of poliovirus transmission, alongside North Waziristan, due to large-scale population movements through Peshawar from across this region, and into other areas of Pakistan. The quality of operations must be urgently improved in Peshawar, and immunization activities urgently resumed in North Waziristan.
Central Africa
:: In Equatorial Guinea, a new WPV1 case was reported this week from Bata district, Litoral province, with onset of paralysis on 16 March. The total number of WPV1 cases reported from Equatorial Guinea for 2014 is three.
:: Due to continued poliovirus circulation in Cameroon, gaps in surveillance quality and influx of vulnerable populations from Central African Republic (CAR), WHO had elevated the risk assessment of international spread of polio from Cameroon to ‘very high’ in March of 2014.
:: Since confirmation of the outbreak in Cameroon in October, six nationwide campaigns have been conducted. However, the quality of implementation has varied greatly by region, and serious coverage gaps remain. As many as 40% of children remain under-immunized (with 30% having received zero doses) during SIAs.
:: The recent confirmation of new cases in Cameroon has resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on 11-13 April, and implementing nationwide campaigns in May and June. Critical to success will be to ensure substantial improvement in the quality campaigns so that all children are reached multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.
:: Immunity levels and surveillance sensitivity are also being assessed in neighboring countries, in particular in Gabon and the Republic of Congo, and additional immunization activities are being planned in these countries for May.

Militant-infested areas: polio drops to be administered at security checkpoints [Pakistan]
April 15, 2014
BUSINESS RECORDER REPORT/Agence France-Presse
Government officials said Monday they would begin administering polio vaccines to children at security checkpoints in the country’s lawless tribal belt to protect against Taliban attacks. The announcement was made at a ceremony to mark the launch of a three-day anti-polio campaign in Peshawar, and is aimed at children from North Waziristan and other Taliban strongholds.
Farakh Sair Khan, a senior administrative official for the restive tribal areas, told the gathering the new strategy would “vaccinate children belonging to areas that are not accessible for the polio workers.” “North Waziristan is affected most by the polio virus and unfortunately we had not been able to vaccinate the children there for security reasons but we are trying to overcome it,” Khan said.
As many as 2643 polio teams will be participating in the campaign to vaccinate children under five, he added. “We will establish over 50 vaccination sites next to the checkpoints of security forces,” said Shahdab Younis, an official of the UNICEF told AFP. “Establishing these sites next to security checkpoints will minimise the risk of attacks,” she added. She said the move would also pressure parents – many of whom believe polio drops are a Western ploy to sterilise Muslims – into allowing their children to be vaccinated, due to the intimidating presence of armed troops. “We have received 37 new cases of polio in the first three months of this year, 33 of them are from North Waziristan,” Younis said.
“Polio vaccination was banned in North Waziristan since 2012 and the children there have not been vaccinated against polio since,” she added. Meanwhile, a separate official said talks had begun with the army, whose co-operation would be required. “We are discussing it with the army because most of the security checkpoints belong to (them),” the official told AFP on condition of anonymity.
http://www.brecorder.com/general-news/172/1173270/

Focusing on Hard-to-Reach Children for Polio Vaccination Campaign in Syria
Posted: 13/04/2014 23:12
Huffington Post
Razan Rashidi, UNICEF Syria communications officer
Excerpt
More than six months after confirmation of the first polio case in Syria, Unicef continues to support efforts to tackle the outbreak in all parts of the country. The April nationwide polio round which started this week aims to reach 2.8million children across Syria with a special focus on hard-to-reach children in conflict zones and besieged areas. It is essential that all children are vaccinated; of the 26 confirmed polio cases in five different Syrian governorates, nearly all had not been vaccinated at all or had not participated in enough rounds of the vaccine, according to Unicef and the Syrian Ministry of Health…
…To improve access, Unicef is supporting local NGOs and the Syrian Arab Red Crescent. In Qudsaya city, for example, which has been sealed off for more than a month, local youth volunteers from Child Rights Society (CRS) are helping out. “We ride a bus and I use a loud speaker, calling parents to bring their under five children for the polio drops,” says a CRS volunteer.
Last month, more than 75,000 children were vaccinated in areas which were previously classified as inaccessible. “Some parents were totally unaware of the outbreak and the vital need for vaccination,” says another volunteer vaccinator. “The use of mosques to announce the campaign proved to be useful.” Unicef is supporting a national communication plan to raise awareness of the campaign among parents.
“It is very positive to see an increase in the number of vaccinated children across Syria,” says Youssouf Abdel-Jelili, Unicef Representative in Syria. “There is still work to be done to reach every child.”
It is estimated that 104,000 children have not been vaccinated in any of the five rounds to date, mainly in East and West Ghouta areas of Rural Damascus Governorate, including parts of Douma district and some villages in Zabadani district.
The support of many donors, including the Governments of Germany and Kuwait, and the UK Department for International Development (DfID), has been vital. Unicef has provided the Ministry of Health with 15million doses of polio vaccine in support of the campaign, and placed an order for an additional three million to cover the May round.
Full text: http://www.huffingtonpost.co.uk/razan-rashidi/syria-humanitarian-aid_b_5131941.html?utm_hp_ref=uk